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Bone cement implantation syndrome: the role of echocardiography and multidisciplinarity
  1. Tiago Castro Pinto1,
  2. Daniel Seabra2,
  3. Ana Castro3 and
  4. Carolina Guedes1
  1. 1Department of Medicine, Hospital Pedro Hispano, Matosinhos, Portugal
  2. 2Department of Cardiology, Hospital Pedro Hispano, Matosinhos, Portugal
  3. 3Department of Anesthesiology, Hospital Pedro Hispano, Matosinhos, Portugal
  1. Correspondence to Dr Tiago Castro Pinto; tiagocpinto28{at}gmail.com

Abstract

Bone cement implantation syndrome (BCIS) is a potentially serious complication after joint replacement surgery, resulting from bone marrow debris and cement embolisation, culminating in pulmonary and cardiovascular collapse. Echocardiography aids in diagnosis and management. We present a woman in her 80s with grade II BCIS. CT angiogram was inconclusive, but echocardiography revealed hyperechogenic material and right ventricular dysfunction, confirming the diagnosis. She received cardiovascular and respiratory support in a level II intensive care unit, showing full recovery of the right ventricle function when it was later reassessed. This potentially fatal condition is successfully managed if recognised early with adequate supportive care. Echocardiography might guide the diagnosis, consolidating supportive measures.

  • cardiovascular medicine
  • emergency medicine
  • hip prosthesis implantation
  • adult intensive care

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Footnotes

  • Contributors TCP, DS, AC and CG were responsible for drafting the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content and gave final approval of the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.